Which of the following is recommended in a woman with Antiphospholipid Antibodies and history of prior aboions / still bih.
**Core Concept**
Antiphospholipid Syndrome (APS) is an autoimmune disorder characterized by the presence of antiphospholipid antibodies, leading to thrombosis and pregnancy complications, including recurrent miscarriages and stillbirths. The syndrome is often associated with a hypercoagulable state.
**Why the Correct Answer is Right**
Low-dose aspirin is recommended in pregnant women with APS to reduce the risk of recurrent miscarriages and stillbirths. This is because aspirin inhibits platelet aggregation, thereby reducing the risk of thrombosis and improving fetal outcomes. The mechanism of action involves the inhibition of cyclooxygenase-1 (COX-1), which leads to a decrease in thromboxane A2 production, a potent platelet aggregator.
**Why Each Wrong Option is Incorrect**
**Option A:** Heparin is sometimes used in APS, but it is not the first-line treatment for pregnant women with a history of recurrent miscarriages/stillbirths.
**Option B:** Warfarin is contraindicated in pregnancy due to its teratogenic effects and increased risk of fetal bleeding.
**Option C:** Low-molecular-weight heparin (LMWH) may be used in APS, but it is typically reserved for patients with a history of thrombosis or those who are unable to tolerate aspirin.
**Clinical Pearl / High-Yield Fact**
In pregnant women with APS, the combination of low-dose aspirin and heparin may be used to reduce the risk of recurrent miscarriages and stillbirths.
**Correct Answer:** A. Low-dose aspirin.